Analysis of recent ACA numbers in California revealed a surprising statistic: Hispanics and Millennials are signing up for the ACA Exchange at half the rate of Non-Hispanics. While initial assumptions pointed to the highly publicized challenges shared by most consumers during the initial enrollment period, deeper delving by Santiago Solutions Group (SSG) indicates that Hispanics and Millennials share a common problem which affected their low ACA enrollment levels: a Healthcare literacy gap.

Analysis of recent ACA numbers in California revealed a surprising statistic: Hispanics and Millennials are signing up for the ACA Exchange at half the rate of Non-Hispanics. While initial assumptions pointed to the highly publicized challenges shared by most consumers during the initial enrollment period, deeper delving by Santiago Solutions Group (SSG) indicates that Hispanics and Millennials share a common problem which affected their low ACA enrollment levels: a Healthcare literacy gap. Growth leaders and insurers are turning their attention toward immediate action plans that can correct this common – and very fixable – problem.

Few would argue that explaining the ACA Exchange complexities could be daunting, even for those in the Healthcare world. Discussions with providers, health insurers, ACA service reps, and consumers, exposed incongruities about how the various “metal” plans actually function, and what anticipated and unanticipated out-of-pocket fees would fall to consumers if they become ill under each plan, including the deductibles, premiums, co-pays, limits, minimums and maximums. Those different interpretations make it difficult for even previously health insured consumers to navigate easily through the ACA Exchange selection and enrollment process.

But for Hispanics and Millennials, the Healthcare literacy gap is even greater. For Millennials, one must consider that most are being presented for the first time with independent insurance decision-making, and are vastly unfamiliar with how the health insurance system works. They would likely have been recently under their parents’ plan or a college plan and have little first-hand experience with the industry terms, what factors to consider, what questions to ask, how deductibles may differ from car insurance plans, and what health insurance plan is best and most cost-effective for their lifestyle.

Hispanics have an equally large Healthcare literacy gap, but for different reasons. Many ACA eligible Hispanics have not had much interaction with the healthcare system overall. Especially at the 139-400 FPL (Federal Poverty Level), many may have been covered by a “Healthy Kids” plan from their state, which was likely basic, without much freedom of choice. In many cases, their parents likely lacked health insurance, while living in a culture of wellness, homeopathic remedies and doctor visits only when absolutely needed.

Hispanics in this FPL who did have commercial health insurance through employers were typically offered a limited selection of low cost plans within narrow and highly restricted HMOs. Hispanics often encountered negative experiences on many levels while trying to access healthcare, including: long wait-times, deteriorated facilities, unwelcoming staff, confusing customer service (with and without translators), long commutes to find in-network specialists, and limited providers who could offer true in-language/in-culture care. Friends and family shared similar negative word-of-mouth cautions about the healthcare system. For those Hispanics trying to learn how to navigate the system, healthcare “education” generally came from an influential colleague who offered advice based on first-hand trial and error, or anecdotal hearsay.

Given the negative imprints arising from their past healthcare and health insurance experiences, it stands to reason that many Hispanics are cautious, anxious and mistrusting of the new ACA Exchange system. Furthermore, as they confront the complex, intimidating ACA selection and enrollment process — without adequate Healthcare literacy and “education” — many Hispanics and Millennials will understandably opt to procrastinate or avoid ACA enrollment completely.

Insurers can begin to correct the course and engage non-enrolled, ACA eligible Hispanics and Millennials by taking several key steps to close the Healthcare literacy gap and expanding their understanding of several key cultural & segments characteristics:

Create Relevant & Relatable Material – Closing the gap requires material and messaging which directly addresses the relevant issues and concerns which are keeping Hispanics and Millennials at bay. Many Hispanics, for example, prefer controlled monthly budgeting and live by a “plan ahead, buy only what you can pay with cash at the moment” mindset. Within the ACA Exchange, the predictable and unanticipated out-of-pocket expenses vary greatly when illnesses arise, making cost management an important factor to address in any Healthcare literacy education program. By comparison, both Millennials and Hispanics understand and relate to the concept of auto insurance and deductibles, with its predictable monthly premiums and out-of-pocket costs.

Leverage Personal Circles-of-Influence – Both Hispanics and Millennials are highly social and stay strongly connected through social media and word-of-mouth within social-family circles. Build relationships within their circles of influence to help “educate” and close the Healthcare literacy gap and change negative impressions of the Healthcare system and ACA Exchange. Consider partnerships with influencers, such as media personalities, leaders, businesses, and community organizations, and maintain a community presence to establish a strong brand image and learn about your customer and their needs.

Create Stellar Customer Experiences with New ACA Customers – Currently enrolled ACA Exchange customers with positive experiences become “ambassadors” for your brand, bringing non-enrolled, ACA-eligible family/friends into the fold. Given the historically negative historical experiences and challenges through the ACA Exchanges process, it becomes important to go beyond the status quo in customer service and rise above to turn strongly negative customer perceptions around. Examine all customer point-of-contact areas to insure every experience is stellar and positive, from Enrollment and Welcome Packages to Payment and Claims Processing, from In-language/In-culture Materials and Service Providers to Help Desks and online/chat/mail, and service centers.

Construct Efficient, Reliable Mobile/Online Communications– For the hyper-connected, hyper-informed, trust-seeking Millennials & Hispanics communication is key. It must be clear, quick, and efficient, particularly with mobile and online channels. Short video formats can be more effective than written content. To reduce customer effort & channel switching, be sure all apps and online systems work. Particularly with Millennials who are always on the move and on mobile devices, if it doesn’t work, they tend to be impatient and move on, sometimes not returning. It must be relevant, relatable, empathic, and in the language of preference, with the on-going goal of customer satisfaction.

With the next enrollment period only 8 months away, there is still time to overcome barriers, turn around historic and current customer impressions, and boost enrollment. SSG stands ready to partner with you to help close the Healthcare literacy gap, set forth a winning Customer Experience, and capture this potential. (For more detail on potential ACA customer experience wins, go to our Webinars Page)